Factors Affecting the Likelihood of Receiving Cesarean Section : Among Low And High Socio-economic Groups In Public Health Facilities In Mali

Mali free cesarean policy benefits more to the rich women than to the poor ones. Thus the purpose of the study is to determine the non-medical factors affecting the likelihood of receiving cesarean among low and high socio-economic groups in public health facilities in Mali; and to draw some recommendations which will favor more indigent women for a safe motherhood. Data from a cross sectional survey by USAID funded program ATN plus conducted from February to September 2010 was used as secondary data. Three thousand nine hundred and sixty eight women delivering in forty one randomly selected health facilities were evaluated on their socio-economic, demographic and medical factors affecting the cesarean probability. A binomial probit and multinomial probit models were used to figure out first the factors affecting the C-section rate; then to determine the relationship between the medical and the non-medical factors of women. Bergson social welfare is needed through some policies to favor more the neediest women for a better access to health care services. Girls' education, and safe delivery in health facilities should be promoted.